Exploratory Evaluation of Hepatic Venous Pressure Gradient, Indocyanine Green Retention, and Liver Stiffness…

Cohort studyCancers· Jul 2026

Exploratory Evaluation of Hepatic Venous Pressure Gradient, Indocyanine Green Retention, and Liver Stiffness in Predicting Short-Term Outcomes After Liver Resection in Patients with Cirrhosis: A Multicenter Prospective Study.

Gianluca Cassese, Mariano Cesare Giglio, Nadia Russolillo … Roberto Ivan Troisi

OncologyCohort studyDiagnosisQ1IF 4.9

Hepatic venous pressure gradient best predicts postoperative complications after liver resection in cirrhosis

Exploratory Evaluation of Hepatic Venous Pressure Gradient, Indocyanine Green Retention, and Liver Stiffness in Predicting Short-Term Outcomes After Liver Resection in Patients with Cirrhosis: A Multicenter Prospective Study.

Gianluca Cassese … Roberto Ivan Troisi

Cancers · Jul 2026

Background

The correct risk stratification is the key to achieving a low postoperative mortality after liver resection for HCC, including the evaluation of liver function and the presence of portal hypertension.

Purpose

The aim of this study was to evaluate the accuracy of Hepatic Venous-Portal pressure Gradients (HVPG), Indocyanine Green retention test (ICG-R15) and Liver Stiffness (LSM) in predicting the risk of post-hepatectomy liver failure and major postoperative complications in selected cirrhotic patients.

Methods

A multicenter prospective study was designed, including consecutive cirrhotic patients undergoing liver resection for HCC.

Results

higher pressure gradient predicts complications better than liver stiffness or ICG tests

AUC 0.78 (95% CI 0.64 to 0.90)

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0.64

0.90

CI excludes the null - significant

More results

Twelve patients (12.2%) developed at least one of the complications included within the composite endpoint.

More results

Three patients (3%) developed post-hepatectomy liver failure (post-hepatectomy liver failure) (one graded A and two graded C according to the International Study Group of Liver Surgery), five patients (5.1%) developed large ascites, five patients (5.1%) developed severe postoperative complications, two patients (2%) died during the hospital stay (post-hepatectomy liver failure).

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Conclusion

In our cohort of selected HCC patients undergoing elective surgery, the predictive ability of HVPG on developing a composite endpoint including post-hepatectomy liver failure, in-hospital mortality, large postoperative ascites and major postoperative complications is higher than LSM and ICG-R15.

Exploratory Evaluation of Hepatic Venous Pressure Gradient, Indocyanine Green Retention, and Liver Stiffness in Predicting Short-Term Outcomes After Liver Resection in Patients with Cirrhosis: A Multicenter Prospective Study.

Exploratory Evaluation of Hepatic Venous Pressure Gradient, Indocyanine Green Retention, and Liver Stiffness in Predicting Short-Term Outcomes After Liver Resection in Patients with Cirrhosis: A Multicenter Prospective Study.

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